CAPSULAR MANAGEMENT AND REFRACTIVE ERROR IN PEDIATRIC INTRAOCULAR LENSES

Background: Guidelines for intraocular lens (IOL) implantation in chil dren regarding patient selection, age limitations, operative technique s, including management of the posterior capsule, and refractive goals are not universally agreed on. Methods: The authors placed posterior chamber IOLs in the capsular bag of 79 eyes in 57 children. Patient ag e ranged from 10 months to 17 years. Follow-up averaged 2 years. Patie nts were selected on the basis of age, cataract morphology, laterality , and lack of potential complicating factors. In general, postoperativ e refractions were intended to be mildly hyperopic with the magnitude dependent on patient age. Results: Seventy-nine percent of patients ab le to report a postoperative visual acuity showed 20/40 or better visu al acuity. Vision was limited by amblyopia in the remaining patients. There were no significant complications. The posterior capsule opacifi ed on average 2 years after surgery regardless of patient age. Conclus ions: Implantation of posterior chamber IOLs in carefully selected chi ldren appears to be effective and safe, Consideration should be given to primary posterior capsulectomy-anterior vitrectomy at the time of l ens implant in children who are not expected to be candidates for yttr ium aluminum garnet (YAG) capsulotomy within 18 months of surgery.